Cancer Screening Guidelines Are Not Simple, But They Could Be Less Complex
Authors: Russell P. Harris, Linda S. Kinsinger
Journal: Annals of Internal Medicine (2022)

EditorialsNovember 2022Cancer Screening Guidelines Are Not Simple, But They Could Be Less ComplexRussell P. Harris, MD, MPH and Linda S. Kinsinger, MD, MPHRussell P. Harris, MD, MPHUniversity of North Carolina School of Medicine and Cecil G. Sheps Center for Health Services Research, Chapel Hill, North CarolinaSearch for more papers by this author and Linda S. Kinsinger, MD, MPHWeaverville, North CarolinaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-2599 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Guideline development for cancer screening seems straightforward: Choose the intervention of interest, identify the potential outcomes (benefits and harms) of doing the intervention versus not, conduct a systematic evidence review to complete an outcomes table, and then convene experts to weigh benefits against harms to make recommendations. However, the more you think about it, the more complex guideline development becomes.First, the intervention must be standardized. If we are interested in a screening program, for instance, we have to consider whether the initial screening test is done the same way everywhere. For example, is mammography digital or digital tomography, single-read ...References1. Harris RP, Helfand M, Woolf SH, et al; Methods Work Group, Third US Preventive Services Task Force. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20:21-35. [PMID: 11306229] CrossrefMedlineGoogle Scholar2. Institute of Medicine. Clinical Practice Guidelines We Can Trust. National Academies Pr; 2011. Google Scholar3. U.S. Preventive Services Task Force. Procedure Manual. Updated August 2022. Accessed at www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/procedure-manual on 24 August 2022. Google Scholar4. Kamineni A, Doria-Rose VP, Chubak J, et al. Evaluation of harms reporting in U.S. cancer screening guidelines. Ann Intern Med. 2022;175:1582-90. doi:10.7326/M22-1139 LinkGoogle Scholar5. DeFrank JT, Barclay C, Sheridan S, et al. The psychological harms of screening: the evidence we have versus the evidence we need. J Gen Intern Med. 2015;30:242-8. [PMID: 25150033] doi:10.1007/s11606-014-2996-5 CrossrefMedlineGoogle Scholar6. Cotter AR, Vuong K, Mustelin L, et al. Do psychological harms result from being labelled with an unexpected diagnosis of abdominal aortic aneurysm or prostate cancer through screening? A systematic review. BMJ Open. 2017;7:e017565. [PMID: 29237653] doi:10.1136/bmjopen-2017-017565 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Russell P. Harris, MD, MPH; Linda S. Kinsinger, MD, MPHAffiliations: University of North Carolina School of Medicine and Cecil G. Sheps Center for Health Services Research, Chapel Hill, North CarolinaWeaverville, North CarolinaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-2599.Corresponding Author: Russell P. Harris, MD, MPH; e-mail, [email protected].unc.edu.This article was published at Annals.org on 27 September 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvaluation of Harms Reporting in U.S. Cancer Screening Guidelines Aruna Kamineni , V. Paul Doria-Rose , Jessica Chubak , John M. Inadomi , Douglas A. Corley , Jennifer S. Haas , Sarah C. Kobrin , Rachel L. Winer , Jennifer Elston Lafata , Elisabeth F. Beaber , Joshua S. Yudkin , Yingye Zheng , Celette Sugg Skinner , Joanne E. Schottinger , Debra P. Ritzwoller , Jennifer M. Croswell , and Andrea N. Burnett-Hartman Metrics November 2022Volume 175, Issue 11Page: 1610-1611KeywordsCancer preventionCancer screeningEvidence based medicineScreening guidelines ePublished: 27 September 2022 Issue Published: November 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...